Webb Patrick, Ghosh Shibani, Shrestha Robin, Namirembe Grace, Gurung Sabi, Sapkota Diplav, Bell Winnie Fay, Davis Dale, Kennedy Eileen, Neupane Shailes, Manohar Swetha, Baral Kedar
Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
Patan Academy of Health Sciences, Patan, Nepal.
Food Nutr Bull. 2016 Dec;37(4 suppl):S170-S182. doi: 10.1177/0379572116674856.
Global commitments to nutrition have supported calls for better evidence to support effective investments at national level. However, too little attention has so far been paid to the role of governance in achieving impacts.
This article explores the ways by which the commitment and capabilities of policy implementers affect collaborative efforts for achieving nutrition goals.
Over 1370 structured interviews were held with government and nongovernment officials over 3 years in 21 districts. Coded responses supported quantitative analysis of stakeholders' knowledge, attitudes, and practices regarding policy implementation.
Stakeholder commitment was already high in 2013 when a new national policy was adopted, but capabilities were weak. Only one-third of interviewed respondents had any nutrition training. Rollout of training focusing on districts targeted for early implementation of multisector programming. This raised levels of nutrition training among interviewed respondents to 57% in 2015, which raised demand for technical information to support actions. Better understanding of the complexity of cross-sector work led to calls for higher budgets and more effective cross-sectoral collaboration.
Nepal offers an example of effective efforts to improve nutrition governance across sectors at all levels of administration. The promotion of awareness, capacity, and new ways of working shows promise. Trainings, information sharing, and management support led to growing willingness among civil servants to engage across sectors. Structured surveys offer a viable way to track change across institutions and sectors.
全球营养承诺支持了关于获取更好证据以支持国家层面有效投资的呼吁。然而，迄今为止，治理在实现影响方面的作用却很少受到关注。
本文探讨政策实施者的承诺和能力影响实现营养目标的协作努力的方式。
在3年时间里，对21个地区的政府和非政府官员进行了1370多次结构化访谈。编码后的回答支持了对利益相关者关于政策实施的知识、态度和实践的定量分析。
2013年一项新的国家政策出台时，利益相关者的承诺已经很高，但能力较弱。只有三分之一的受访对象接受过任何营养培训。针对早期实施多部门规划的地区开展培训推广。这使得2015年受访对象中的营养培训水平提高到57%，这增加了对支持行动的技术信息的需求。对跨部门工作复杂性的更好理解引发了对更高预算和更有效跨部门协作的呼吁。
尼泊尔提供了一个在各级行政管理中跨部门有效改善营养治理的范例。提高认识、能力以及新的工作方式显示出了前景。培训、信息共享和管理支持使公务员跨部门参与的意愿不断增强。结构化调查为跟踪各机构和部门的变化提供了一种可行的方法。
